Association between ambient temperature and chronic rhinosinusitis

Runming Du, Wangteng Jiao, Junxiong Ma, Qinfeng Zhou, Zhi Sheng Liang, Shengzhi Sun, Omar G. Ahmed, Nicholas R. Rowan, Jayant M. Pinto, Murugappan Ramanathan, Zhenyu Zhang

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Chronic exposure to particulate matter air pollution (PM2.5) is associated with chronic rhinosinusitis (CRS). Elevated ambient temperature may increase PM2.5 levels and thereby exacerbate sinonasal symptoms. This study investigates the association between high ambient temperature and the risk of CRS diagnosis. Methods: Patients with CRS were diagnosed at Johns Hopkins hospitals from May to October 2013–2022, and controls were matched patients without CRS meanwhile. A total of 4752 patients (2376 cases and 2376 controls) were identified with a mean (SD) age of 51.8 (16.8) years. The effect of maximum ambient temperature on symptoms was estimated with a distributed lag nonlinear model (DLNM). Extreme heat was defined as 35.0°C (95th percentile of the maximum temperature distribution). Conditional logistic regression models estimated the association between extreme heat and the risk of CRS diagnosis. Results: Exposure to extreme heat was associated with increased odds of exacerbation of CRS symptoms (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.03–1.19). The cumulative effect of extreme heat during 0–21 lag days was significant (OR 2.37, 95% CI 1.60–3.50) compared with the minimum morbidity temperature (MMT) at 25.3°C. Associations were more pronounced among young and middle-aged patients and patients with abnormal weight. Conclusions: We found that short-term exposure to high ambient temperature is associated with increased CRS diagnosis, suggesting a cascading effect of meteorological phenomena. These results highlight climate change's potentially deleterious health effects on upper airway diseases, which could have a significant public health impact.

Original languageEnglish (US)
Pages (from-to)1906-1914
Number of pages9
JournalInternational Forum of Allergy and Rhinology
Issue number10
Early online dateMar 10 2023
StatePublished - Oct 2023


  • ambient temperature
  • chronic rhinosinusitis
  • distributed lag nonlinear model
  • matched case–control study

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology


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